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Covid-19 has cut more than two years from life expectancy in 16 U.S. states in the past year, with the worst damage concentrated in the Sun Belt and the Great Plains.

In Texas, Covid-19 caused an implied reduction in life expectancy at birth of 2.6 years to 76.4 in the twelve months ending in September, according to an analysis of death statistics from University of California at Los Angeles sociology professor Patrick Heuveline, an update of data originally published in the BMJ Open journal.

In Arizona, the reduction was 2.6 years to 77.2 and in South Dakota, 2.5 years to 76.8. That’s a dramatic shift from the first year of the pandemic, when Northeast states topped the list.

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Covid-19 has been consistently among the leading causes of death in the U.S., but the widely-used deaths per capita metric can sometimes lead to misleading conclusions, because it fails to consider the effect population age has on outcomes. The virus is many orders of magnitude more deadly for the elderly as opposed to the young, but Heuveline’s data takes age and gender into account to make comparisons possible.

Nationwide, Covid cut life expectancy by 1.5 years to 78.7 in the twelve months ended Sept. 30, according to Heuveline’s data.

Covid-19 has caused more than 721,000 deaths in the U.S., more than any other pandemic, and the highest toll of any country.